Rice: a common and severe cause of food protein-induced enterocolitis syndrome.
OBJECTIVE
To examine and compare the characteristics of food protein-induced enterocolitis syndrome (FPIES) caused by rice and cow's milk/soy.


METHODS
Retrospective study of children presenting with FPIES to the Children's Hospital at Westmead, NSW, Australia, over a 16-year period.


RESULTS
There were 14 children with 26 episodes of rice FPIES compared with 17 children with 30 episodes of cow's milk (n = 10) or soy (n = 7) FPIES. Children with rice FPIES were more likely to have FPIES caused by other foods (36%) than children with FPIES caused by cow's milk/soy (0%). Rice caused more episodes of FPIES before a correct diagnosis was made (median 4 (range 1-4) vs median 2 (range 1-4)) and triggered more severe reactions with higher rates of intravenous fluid resuscitation (42% vs 17%) than reactions caused by cow's milk/soy.


CONCLUSIONS
This study highlights the emerging importance of rice, a food commonly thought to be "hypoallergenic", as a significant trigger of FPIES. Paediatricians should be aware that rice not only has the potential to cause FPIES, but that such reactions tend be more severe than those caused by cow's milk/soy.
Mehr
S S
SS
Department of Allergy and Immunology, The Children's Hospital at Westmead, Sydney, Australia.
Kakakios
A M
AM
Kemp
A S
AS
D004044:Dietary Proteins / Q000009:adverse effects*; D004760:Enterocolitis / Q000209:etiology*; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007223:Infant; D008297:Male; D016269:Milk Hypersensitivity / Q000150:complications / Q000175:diagnosis; D012275:Oryza / Q000009:adverse effects*; D012189:Retrospective Studies; D041942:Soy Milk; D013577:Syndrome
D004044:Dietary Proteins